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TIMOTHY FULLER LCSW
NPI 1114567807
Social Worker - Clinical in Portland, ME

Active since January 09, 2020PECOS Enrolled
844 STEVENS AVE, PORTLAND, ME 04103(207) 505-0227 Get Directions Write a Review

NPPES record last updated: December 16, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 16, 2025, Jan 26, 2023, Jan 9, 2020 (3 updates tracked since 2020).

About Timothy Fuller Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY FULLER LCSW (NPI 1114567807) is an individual clinical provider in Portland, Maine, licensed in Maine (LC21772) and active in the NPI registry since January 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1114567807
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameTIMOTHY FULLERCredential: LCSW
Location Address844 STEVENS AVEPortland, ME 04103-2676
Mailing Address844 Stevens AvePortland, ME 04103-2676 · (207) 505-0227
Phone(207) 505-0227
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJanuary 9, 2020
Last NPPES UpdateDecember 16, 20253 updates tracked since enumeration
NPPES CertifiedDecember 16, 2025
✔ NPI 1114567807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in ME · LC21772
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
844 STEVENS AVE, Portland, ME 04103
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Timothy Fuller Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5799261178
PECOS Enrollment IDI20260115002692
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.28 – $169.96
Typical copayment $0.00 (range $14.07 – $42.49)
Most-billed visit code NA
Established Patient
$70.13 typical visit price
range $18.22 – $138.92
Typical copayment $17.53 (range $4.55 – $34.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVERGREEN PSYCHOTHERAPY
Social Worker (Clinical)
844 STEVENS AVE
PORTLAND, ME 04103
Cumberland County (508) 243-3580
DAYLA JENEY
Counselor (Mental Health)
844 STEVENS AVE
PORTLAND, ME 04103
Cumberland County (207) 491-7620
CHAOS AND COMPASSION LLC
Social Worker (Clinical)
844 STEVENS AVE
PORTLAND, ME 04103
Cumberland County (207) 505-0227

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Fuller's NPI number?

The NPI number for Timothy Fuller is 1114567807. It was assigned to this individual provider in the NPPES registry on January 9, 2020.

Where is Timothy Fuller located?

Timothy Fuller practices at 844 Stevens Ave, Portland, ME 04103. The listed phone number is (207) 505-0227.

What is Timothy Fuller's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Timothy Fuller enrolled in Medicare?

Yes. Timothy Fuller is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Timothy Fuller was last updated on December 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.